Non-communicable disease

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Non-communicable disease
A nurse with a non-communicable diseases kit, Fiji, 2012. Photo- DFAT (13253315924).jpg
A nurse with a non-communicable diseases kit, Fiji, 2012.

A non-communicable disease (NCD) is a disease that is not transmissible directly from one person to another. NCDs include Parkinson's disease, autoimmune diseases, strokes, heart diseases, cancers, diabetes, chronic kidney disease, osteoarthritis, osteoporosis, Alzheimer's disease, cataracts, and others. NCDs may be chronic or acute. Most are non-infectious, although there are some non-communicable infectious diseases, such as parasitic diseases in which the parasite's life cycle does not include direct host-to-host transmission.

Contents

The four main NCDs that are the leading causes of death globally, are cardiovascular disease, cancer, chronic respiratory diseases, and diabetes. NCDs account for seven out of the ten leading causes of death worldwide. [1] Figures given for 2019 are 41 million deaths due to NCDs worldwide. Of these 17.9 million were due to cardiovascular disease; 9.3 million due to cancer; 4.1 million to chronic respiratory diseases, and 2.0 million to diabetes. [2] Over 80% of the deaths from these four groups were premature, not reaching the age of 70. [1]

Risk factors such as a person's background, lifestyle and environment increase the likelihood of certain NCDs. Every year, at least 5 million people die because of tobacco use and about 2.8 million die from being overweight. High cholesterol accounts for roughly 2.6 million deaths and 7.5 million die because of high blood pressure.

Risk factors

Risk factors such as a person's background; lifestyle and environment are known to increase the likelihood of certain non-communicable diseases. They include age, gender, genetics, exposure to air pollution, and behaviors such as smoking, unhealthy diet and physical inactivity which can lead to hypertension and obesity, in turn leading to increased risk of many NCDs. Most NCDs are considered preventable because they are caused by modifiable risk factors.

The WHO's World Health Report 2002 identified five important risk factors for non-communicable disease in the top ten leading risks to health. These are raised blood pressure, raised cholesterol, tobacco use, alcohol consumption, and being overweight. The other factors associated with higher risk of NCDs include a person's economic and social conditions, also known as the social determinants of health.

It has been estimated that if the primary risk factors were eliminated, 80% of the cases of heart disease, stroke and type 2 diabetes and 40% of cancers could be prevented. Interventions targeting the main risk factors could have a significant impact on reducing the burden of disease worldwide. Efforts focused on better diet and increased physical activity have been shown to control the prevalence of NCDs .

Environmental diseases

NCDs include many environmental diseases covering a broad category of avoidable and unavoidable human health conditions caused by external factors, such as sunlight, nutrition, pollution, and lifestyle choices. The diseases of affluence are non-infectious diseases with environmental causes. Examples include:

Inherited diseases

Genetic disorders are caused by errors in genetic information that produce diseases in the affected people. The origin of these genetic errors can be:

Cystic fibrosis is an example of an inherited disease that is caused by a mutation on a gene. The faulty gene impairs the normal movement of sodium chloride in and out of cells, which causes the mucus-secreting organs to produce abnormally thick mucus. The gene is recessive, meaning that a person must have two copies of the faulty gene for them to develop the disease. Cystic fibrosis affects the respiratory, digestive and reproductive systems, as well as the sweat glands. The mucus secreted is very thick and blocks passageways in the lungs and digestive tracts. This mucus causes problems with breathing and with the digestion and absorption of nutrients.

  • Dominant genetic diseases, such as Huntingtons, require the inheritance of one erroneous gene to be expressed.
  • Recessive genetic diseases require the inheritance of erroneous genes to be expressed and this is one reason they work together.

Global health

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Deaths from noncommunicable diseases per million persons in 2012
  688-2,635
  2,636-2,923
  2,924-3,224
  3,225-3,476
  3,477-4,034
  4,035-4,919
  4,920-5,772
  5,773-7,729
  7,730-8,879
  8,880-13,667

Referred to as a "lifestyle" disease, because the majority of these diseases are preventable illnesses, the most common causes for non-communicable diseases (NCD) include tobacco use (smoking), hazardous alcohol use, poor diets (high consumption of sugar, salt, saturated fats, and trans fatty acids) and physical inactivity. Currently, NCD kills 36 million people a year, a number that by some estimates is expected to rise by 17–24% within the next decade. [3]

Historically, many NCDs were associated with economic development and were so-called a "diseases of the rich". The burden of non-communicable diseases in developing countries has increased however, with an estimated 80% of the four main types of NCDs — cardiovascular diseases, cancers, chronic respiratory diseases and diabetes — now occurring in low- and middle-income countries. Action Plan for the Global Strategy for the Prevention and Control of non-communicable Diseases and with two-thirds of people who are affected by diabetes now residing in developing nations, NCD can no longer be considered just a problem affecting affluent estimation of the economic impact of chronic non-communicable diseases in selected countries. New WHO report: deaths from non-communicable diseases are on the rise, with developing world hit hardest. As previously stated, in 2008 alone, NCD's were the cause of 63% of deaths worldwide; a number that is expected to rise considerably in the near future if measures are not taken.

If present growth trends are maintained, by 2020, NCDs will attribute to 7 out of every 10 deaths in developing countries, killing 52 million people annually worldwide by 2030. With statistics such as these, it comes as no surprise that international entities such as the World Health Organization & World Bank Human Development Network have identified the prevention and control of NCDs as an increasingly important discussion item on the global health agenda.

Thus, should policy makers and communities mobilize "and make prevention and targeted treatment of such diseases a priority," sustainable measures can be implemented to stagnate (and eventually even reverse) this emerging global health threat. Potential measures currently being discussed by the(World Health Organization)-Food and Agriculture Organization includes reducing the levels of salt in foods, limiting inappropriate marketing of unhealthy foods and non-alcoholic beverages to children, imposing controls on harmful alcohol use, raising taxes on tobacco, and legislating to curb smoking in public places.

United Nations

The World Health Organization is the specialized agency of the United Nations (UN) that acts as coordinating authority on international public health issues, including NCDs. In May 2008, the 193 Member States of the WHO approved a six-year plan to address non-communicable diseases, especially the rapidly increasing burden in low- and middle-income countries. The plan calls for raising the priority given to NCDs in international development work'.

During the 64th session of the United Nations General Assembly in 2010, a resolution was passed to call for a high-level meeting of the General Assembly on the prevention and treatment NCDs with the participation of heads of state and government. The resolution also encouraged UN Member States to address the issue of non-communicable diseases at the 2010 Review Summit for the Millennium Development Goals.

Global Non-communicable Disease Network

In order to better coordinate efforts around the globe, in 2009 the WHO announced the launch of the Global Non-communicable Disease Network (NCDnet). [4] NCDnet will consist of leading health organizations and experts from around the world in order to fight against diseases such as cancer, cardiovascular disease, and diabetes. Ala Alwan, assistant director-general for Non-communicable Diseases and Mental Health at the WHO, said: "integrating the prevention of non-communicable diseases and injuries into the national and global development agendas is not only achievable but also a priority for developing countries." [5]

NCD Alliance

The NCD Alliance is a global partnership founded in May 2009 by four international federations representing cardiovascular disease, diabetes, cancer, and chronic respiratory disease. [6] The NCD Alliance brings together roughly 900 national member associations to fight non-communicable disease. Long-term aims of the Alliance include: [7]

  1. NCD/disease national plans for all
  2. A tobacco free world
  3. Improved lifestyles
  4. Strengthened health systems
  5. Global access to affordable and good quality medicines and technologies
  6. Human rights for people with NCDs.

Task Force

The United Nations Interagency Task Force on the Prevention and Control of Non-communicable Diseases (UNIATF) was established by the United Nations Secretary-General in 2013 in order to provide scaled up action across the UN system to support governments, in particular in low- and middle-income countries, to tackle non-communicable diseases. [8]

Young Professionals Chronic Disease Network

The Young Professionals Chronic Disease Network, or commonly referred to as YP-CDN, is a global network of roughly 5000 young professionals across 157 countries. The organization aims to mobilize these young people "to take action against social injustice driven by NCDs.". [9] Now redirected to the Sustainable development knowledge platform. [10]

Economics

Previously, chronic NCDs were considered a problem limited mostly to high income countries, while infectious diseases seemed to affect low income countries. The burden of disease attributed to NCDs has been estimated at 85% in industrialized nations, 70% in middle income nations, and nearly 50% in countries with the lowest national incomes. [11] In 2008, chronic NCDs accounted for more than 60% (over 35 million) of the 57 million deaths worldwide. Given the global population distribution, almost 80% of deaths due to chronic NCDs worldwide now occur in low and middle income countries, while only 20% occur in higher income countries.

National economies are reportedly suffering significant losses due to premature deaths or inability to work resulting from heart disease, stroke, diabetes, and the broader impacts of physical inactivity, which is a significant contributor to NCDs globally. [12] For instance, China is expected to lose roughly $558 billion in national income between 2005 and 2015 due to early deaths. In 2005, heart disease, stroke and diabetes caused an estimated loss in international dollars of national income of 9 billion in India and 3 billion in Brazil. [11]

Absenteeism and presenteeism

The burden of chronic NCDs including mental health conditions is felt in workplaces around the world, notably due to elevated levels of absenteeism, or absence from work because of illness, and presenteeism, or productivity lost from staff coming to work and performing below normal standards due to poor health. For example, the United Kingdom experienced a loss of about 175 million days in 2006 to absence from illness among a working population of 37.7 million people. The estimated cost of absences due to illness was over 20 billion pounds in the same year. [13] The cost due to presenteeism is likely even larger, although methods of analyzing the economic impacts of presenteeism are still being developed. Methods for analyzing the distinct workplace impacts of NCDs versus other types of health conditions are also still being developed.

Key diseases

Cancer

For the vast majority of cancers, risk factors are environmental or lifestyle-related, thus cancers are mostly preventable NCD. [14] Greater than 30% of cancer is preventable via avoiding risk factors including: tobacco, being overweight or obesity, low fruit and vegetable intake, physical inactivity, alcohol, sexually transmitted infections, and air pollution. [15] Infectious agents are responsible for some cancers, for instance almost all cervical cancers are caused by human papillomavirus infection.

Cardiovascular disease

The first studies on cardiovascular health were performed in 1949 by Jerry Morris using occupational health data and were published in 1958. [16] The causes, prevention, and/or treatment of all forms of cardiovascular disease remain active fields of biomedical research, with hundreds of scientific studies being published on a weekly basis. A trend has emerged, particularly in the early 2000s, in which numerous studies have revealed a link between fast food and an increase in heart disease. These studies include those conducted by the Ryan Mackey Memorial Research Institute, Harvard University and the Sydney Center for Cardiovascular Health. Many major fast food chains, particularly McDonald's, have protested the methods used in these studies and have responded with healthier menu options.

A fairly recent emphasis is on the link between low-grade inflammation that hallmarks atherosclerosis and its possible interventions. C-reactive protein (CRP) is a common inflammatory marker that has been found to be present in increased levels in patients at risk for cardiovascular disease. [17] Also osteoprotegerin which involved with regulation of a key inflammatory transcription factor called NF-κB has been found to be a risk factor of cardiovascular disease and mortality. [18] [19]

Diabetes

Type 2 Diabetes Mellitus is a chronic condition which is largely preventable and manageable but difficult to cure. Management concentrates on keeping blood sugar levels as close to normal ("euglycemia") as possible without presenting undue patient danger. This can usually be with close dietary management, exercise, and use of appropriate medications (insulin only in the case of type 1 diabetes mellitus. Oral medications may be used in the case of type 2 diabetes, as well as insulin).

Patient education, understanding, and participation is vital since the complications of diabetes are far less common and less severe in people who have well-managed blood sugar levels. [20] [21] Wider health problems may accelerate the deleterious effects of diabetes. These include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise.

Chronic kidney disease

Although chronic kidney disease (CKD) is not currently identified as one of WHO's main targets for global NCD control, there is compelling evidence that CKD is not only common, harmful and treatable but also a major contributing factor to the incidence and outcomes of at least three of the diseases targeted by WHO (diabetes, hypertension and CVD). [22] CKD strongly predisposes to hypertension and CVD; diabetes, hypertension and CVD are all major causes of CKD; and major risk factors for diabetes, hypertension and CVD (such as obesity and smoking) also cause or exacerbate CKD. In addition, among people with diabetes, hypertension, or CVD, the subset who also have CKD are at highest risk of adverse outcomes and high health care costs. Thus, CKD, diabetes and cardiovascular disease are closely associated conditions that often coexist; share common risk factors and treatments; and would benefit from a coordinated global approach to prevention and control.

Chronic respiratory disease

Chronic respiratory diseases (CRDs) are diseases of the lungs and airways. According to the World Health Organization (WHO) hundreds of millions of people have CRDs. [23] Common CRDs are: Asthma, Chronic obstructive pulmonary disease, Occupational lung disease, and Pulmonary hypertension. [24] While CRDs are not curable, various treatments are available to help improve quality of life for individuals who have them. Most treatments involve dilating major airways to improve shortness of breath among other symptoms. [24] The main risk factors for developing CRDs are: tobacco smoking, indoor and outdoor air pollution, allergens, and occupational risks. [23]

WHO helped launch the Global Alliance against Chronic Respiratory Diseases (GARD) in 2006. [25] GARD is voluntarily composed of national and international organizations and works toward "reducing the global burden of chronic respiratory diseases" and focus mainly on vulnerable populations and low and middle-income countries. [26]

See also

Related Research Articles

<span class="mw-page-title-main">Lifestyle disease</span> Diseases linked with the way people live their life

Lifestyle diseases can be defined as the diseases linked to the manner in which a person lives their life. These diseases are non-communicable, and can be caused by lack of physical activity, unhealthy eating, alcohol, substance use disorders and smoking tobacco, which can lead to heart disease, stroke, obesity, type II diabetes and lung cancer. The diseases that appear to increase in frequency as countries become more industrialized and people live longer include Alzheimer's disease, arthritis, atherosclerosis, asthma, cancer, chronic liver disease or cirrhosis, chronic obstructive pulmonary disease, colitis, irritable bowel syndrome, type 2 diabetes, heart disease, hypertension, metabolic syndrome, chronic kidney failure, osteoporosis, PCOD, stroke, depression, obesity and vascular dementia.

<span class="mw-page-title-main">Cardiovascular disease</span> Class of diseases that involve the heart or blood vessels

Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, arrhythmia, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis.

<span class="mw-page-title-main">Chronic kidney disease</span> Medical condition

Chronic kidney disease (CKD) is a type of kidney disease in which a gradual loss of kidney function occurs over a period of months to years. Initially generally no symptoms are seen, but later symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications can relate to hormonal dysfunction of the kidneys and include high blood pressure, bone disease, and anemia. Additionally CKD patients have markedly increased cardiovascular complications with increased risks of death and hospitalization.

<span class="mw-page-title-main">Preventive healthcare</span> Prevention of the occurrence of diseases

Preventive healthcare, or prophylaxis, is the application of healthcare measures to prevent diseases. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices, and are dynamic processes that begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention.

<span class="mw-page-title-main">Diseases of affluence</span> Health conditions thought to be a result of increasing wealth in society

Diseases of affluence, previously called diseases of rich people, is a term sometimes given to selected diseases and other health conditions which are commonly thought to be a result of increasing wealth in a society. Also referred to as the "Western disease" paradigm, these diseases are in contrast to so-called "diseases of poverty", which largely result from and contribute to human impoverishment. These diseases of affluence have vastly increased in prevalence since the end of World War II.

<span class="mw-page-title-main">Health in India</span> Overview of health in India

India's population in 2021 as per World Bank is 1.39 billion. Being the world's most populous country and one of its fastest-growing economies, India experiences both challenges and opportunities in context of public health. India is a hub for pharmaceutical and biotechnology industries; world-class scientists, clinical trials and hospitals yet country faces daunting public health challenges like child undernutrition, high rates of neonatal and maternal mortality, growth in noncommunicable diseases, high rates of road traffic accidents and other health related issues.

A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term chronic is often applied when the course of the disease lasts for more than three months. Common chronic diseases include diabetes, functional gastrointestinal disorder, eczema, arthritis, asthma, chronic obstructive pulmonary disease, autoimmune diseases, genetic disorders and some viral diseases such as hepatitis C and acquired immunodeficiency syndrome. An illness which is lifelong because it ends in death is a terminal illness. It is possible and not unexpected for an illness to change in definition from terminal to chronic. Diabetes and HIV for example were once terminal yet are now considered chronic due to the availability of insulin for diabetics and daily drug treatment for individuals with HIV which allow these individuals to live while managing symptoms.

<span class="mw-page-title-main">Epidemiological transition</span>

In demography and medical geography, epidemiological transition is a theory which "describes changing population patterns in terms of fertility, life expectancy, mortality, and leading causes of death." For example, a phase of development marked by a sudden increase in population growth rates brought by improved food security and innovations in public health and medicine, can be followed by a re-leveling of population growth due to subsequent declines in fertility rates. Such a transition can account for the replacement of infectious diseases by chronic diseases over time due to increased life span as a result of improved health care and disease prevention. This theory was originally posited by Abdel Omran in 1971.

<span class="mw-page-title-main">Health in Ethiopia</span> Overview of health in Ethiopia

Health in Ethiopia has improved markedly since the early 2000s, with government leadership playing a key role in mobilizing resources and ensuring that they are used effectively. A central feature of the sector is the priority given to the Health Extension Programme, which delivers cost-effective basic services that enhance equity and provide care to millions of women, men and children. The development and delivery of the Health Extension Program, and its lasting success, is an example of how a low-income country can still improve access to health services with creativity and dedication.

<span class="mw-page-title-main">Health in Tajikistan</span> Overview of health in Tajikistan

The Tajikistan health system is influenced by the former Soviet legacy. It is ranked as the poorest country within the WHO European region, including the lowest total health expenditure per capita. Tajikistan is ranked 129th as Human Development Index of 188 countries, with an Index of 0.627 in 2016. In 2016, the SDG Index value was 56. In Tajikistan health indicators such as infant and maternal mortality rates are among the highest of the former Soviet republics. In the post-Soviet era, life expectancy has decreased because of poor nutrition, polluted water supplies, and increased incidence of cholera, malaria, tuberculosis, and typhoid. Because the health care system has deteriorated badly and receives insufficient funding and because sanitation and water supply systems are in declining condition, Tajikistan has a high risk of epidemic disease.

Chronic, non-communicable diseases account for an estimated 80% of total deaths and 70% of disability-adjusted life years (DALYs) lost in China. Cardiovascular diseases, chronic respiratory disease, and cancer are the leading causes of both death and of the burden of disease, and exposure to risk factors is high: more than 300 million men smoke cigarettes and 160 million adults are hypertensive, most of whom are not being treated. An obesity epidemic is imminent, with more than 20% of children aged 7–17 years in big cities now overweight or obese. Rates of death from chronic disease in middle-aged people are higher in China than in some high-income countries.

<span class="mw-page-title-main">Health in Turkey</span> Overview of health in Turkey

The healthcare system in Turkey has improved in terms of health status especially after implementing the Health Transformation Program (HP) in 2003. "Health for All" was the slogan for this transformation, and HP aimed to provide and finance health care efficiently, effectively, and equitably. By covering most of the population, the General Health Insurance Scheme is financed by employers, employees, and government contributions through the Social Security Institution. Even though HP aimed to be equitable, after 18 years of implementation, there are still disparities between the regions in Turkey. While the under-5 mortality rate in Western Marmara is 7.9, the under-5 mortality rate in Southeastern Asia is two times higher than Western Marmara, with the rate of 16.3 in 2021.

Malawi ranks 170th out of 174 in the World Health Organization lifespan tables; 88% of the population live on less than £2.40 per day; and 50% are below the poverty line.

C3 Collaborating for Health is a global, not-for-profit non-governmental organisation, based in London, that exists to find solutions to fight the epidemic of non-communicable diseases (NCDs).

This article provides a global overview of the current trends and distribution of metabolic syndrome. Metabolic syndrome refers to a cluster of related risk factors for cardiovascular disease that includes abdominal obesity, diabetes, hypertension, and elevated cholesterol.

Montenegro is a country with an area of 13,812 square kilometres and a population of 620,029, according to the 2011 census. The country is bordered by Croatia, the Adriatic Sea, Bosnia, Herzegovina, Serbia, Kosovo and Albania. The most common health issues faced are non-communicable diseases accounting for 95% of all deaths. This is followed by 4% of mortality due to injury, and 1% due to communicable, maternal, perinatal and nutritional conditions. Other health areas of interest are alcohol consumption, which is the most prevalent disease of addiction within Montenegro and smoking. Montenegro has one of the highest tobacco usage rates across Europe. Life expectancy for men is 74 years, and life expectancy for women is 79.

The United Nations Interagency Task Force on the Prevention and Control of Non-communicable Diseases (UNIATF), hereafter referred to as the Task Force, was established by the United Nations Secretary-General in 2013. Non-communicable diseases (NCDs), also known as chronic diseases, include cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. The role of the Task Force is to bring relevant actors from across the United Nations (UN) system and national governments together to develop whole-of-government, whole-of-society approaches for the prevention and control of NCDs. Following the establishment of the 2030 Agenda for Sustainable Development in 2015, the Task Force's scope of work was expanded to include “NCD related Sustainable Development Goals (SDGs)” such as addressing mental health conditions, violence, injuries, nutrition and environmental issues that contribute to the global burden of NCDs. The Task Force promotes multisectoral action for the prevention and control of NCDs, supports countries to achieve the Sustainable Development Goals (SDGs) and supports countries to move towards Universal Health Coverage (UHC). The work of the Task Force includes implementing the Global Joint Programme to conduct investment cases, coordinating interagency joint programmes and facilitating thematic working groups. The World Health Organization acts as a Secretariat for the Task Force.

Cardiovascular disease in women is an integral area of research in the ongoing studies of women's health. Cardiovascular disease (CVD) is an umbrella term for a wide range of diseases affecting the heart and blood vessels, including but not limited to, coronary artery disease, stroke, cardiomyopathy, myocardial infarctions, and aortic aneurysms.

<span class="mw-page-title-main">Commercial determinants of health</span>

The commercial determinants of health are the private sector activities that influence individual and group differences in health status. Commercial determinants of health can affect people's health positively or negatively. They are part of the broader social determinants of health.

References

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